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Docetaxel treatment before or after surgery

Burgie
Posts: 14
Joined: Sep 2017

Hello All,

New thread for some that may have read or responded to my others.  I'm the 47 year old with recently diagnosed G9 and metastasized into local lymphes nodes and lower abdomen.   I thught I had my treatment course of action nailed down.  My choices were :

(A) At cancer center "X" - Leuprolide (Lupron) + Abiraterone (Zytiga) + 50% chance of Apalutamide (hormones for 6 months) followed by RP followed by RT and/or Chemo (Docetaxel).  This is a trial so I have to use the surgeon designated for this center.  I'll assume good/reputable.

(B) At cancer center "Y" - Lupron (3 years) + chemo (Docetaxel) for 6 cycles folloed by either RT or surgery (prostate/lymphes nodes/ SV).  After RT then Abiraterone (Zytiga) until the Lurpon cycle ends.

 

After meeting with the surgeon at "Y" I decided I wanted the RP along with any local lymphes nodes removed from THIS surgeon..  The surgeon is very good.  SO I called the Med Onc at "Y" and told him my decision for which he then said if I wanted to do surgery then this would have to be done pre-chemo.  So now "Y" wants to do Lupron + Zytiga for 3-4 months, then RP followed by chemo.

 

Here's the catch. Zytiga is very expensive so if I qualify for the trial at "X" which I am told I do the treatments are very similar my out of pocket costs should be within reason given the treatments.  I want the surgeon at "Y" but there is no trial here so the zytiga cost is (maybe) all mine.  I am still waiting for by insurance to confirm or deny full payment.

 

Question, Has anyone done the Docetaxel prior to surgery?  If so, any comments? Is it best to wait ?  Has there been any success insurance wise with Zytiga ?

 

Thanks

_Burgie

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3250
Joined: May 2012

A few generalities, Burgie, although I myself have never used Taxotere.

Chemo is in most cases a "last hurrah" drug against PCa; the same is true of Breast cancer.  That is, ordinarily employed after everything else has run its course. But as you know from your trials, there are exceptions, and it is not too rare for chemo to be used front-end, as a Pallative while prepping for surgery or whatever.  It's just not the ordinarily flow of treatments.

A friend whom I assisted throughout his last few years received Zytiga back in around 2011 or 2012. All he had was Medicare, and there were no insurace issues for him, as I recall.

I mentioned to you a while back that a new study shows that using Jevtana and Zytiga sooner rather than later with Taxotere has had great results. I would demand that my doctor find and read that study.

I hope others will have some knowledge regading your questions and share with you,

max

 

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